The committee was formed in the wake of the gangrape of a young woman on a moving bus in December. The woman was so badly assaulted that she died of her injuries Dec. 29.

In the wake of that incident, attention has turned to the sexual violence endemic in India, and the treatment of those who have been sexually assaulted by authority figures. Lawyers and groups that deal with rape survivors have described a range of callous treatment by doctors who examine women who report a rape.

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These include making the woman wait for a long time before being examined, not offering her a change of clothes, and not treating her status as a crime victim with confidentiality. When it comes to the medical exam itself, some doctors conduct an unscientific vaginal exam that is both painful and humiliating in the wake of a rape. If the woman is reluctant to have the exam or declines it, some doctors note on the exam report that the victim was “uncooperative,” which can prejudice her legal case.

In a report released Wednesday, the committee said doctors must not conduct the infamous “two-finger” test, used to test the stretchiness of the vagina.

India doesn’t currently have any national guidelines on how doctors should conduct a medical exam in the case of sexual abuse or rape cases. Indian criminal procedure forbids trying to impeach the character of a rape victim on the basis of her past sexual experience. But advocates say that is how the test is commonly used by defense lawyers to show that the victim had a sexual history.

“A test to ascertain the laxity of the vaginal muscles which is commonly referred to as the two-finger test must not be conducted,” said the committee. “On the basis of this test, observations/conclusions such as ‘habituated to sexual intercourse’ should not be made and this is forbidden by law.”

The committee also urged doctors to keep the language of their exam report–known as a “medico-legal certificate”–neutral, and not preempt the legal process.

“The issue of whether sexual assault occurred is a legal issue and not a medical diagnosis,” said the committee, “Consequently, doctors should not, on the basis of the medical examination conclude whether rape had occurred or not.”

The committee’s language on what doctors should do and not do followed the recommendations of key court judgments as well as the suggestions of women’s rights groups such as the Mumbai-based Center for Enquiry Into Health and Allied Themes (CEHAT), which has its own manual on how the exam should be conducted. The CEHAT manual is based on World Health Organization recommendations.

Padma Deosthali of CEHAT said she hoped the Verma committee’s medical recommendations would “act as a catalyst” to the federal government to put out national standards for the exam.

“We’ve been pushing for a national protocol,” she said, but added that in spite of writing to the health ministry for two years, “this is not moving.”

Dr. G.K. Sharma, a senior official at the Directorate General of Health Services, which supervises federal hospitals, said that he could not immediately comment on the Verma committee report.

But, he said, the health ministry was aware of opposition to the “two-finger test” and had acted on that.

Delhi hospitals were advised last year not to conduct manual vaginal exams as a matter of routine and only “in exceptional cases where it is urgent.” He said a manual exam may be required sometimes to check for internal injuries when necessary equipment, such as a speculum, is not available.

This month, in the wake of the outrage over the Dec. 16 rape, Dr. Sharma said the advisory was also sent to the heads of health departments and medical education in every state.

“In the beginning of this year only we have already issued some guidelines where we had advised them not to do the finger test,” he said.

Even so, the test is unlikely to vanish immediately, especially from smaller towns and hospitals, on the basis of a few notifications.

Women’s groups say it requires follow-up and specific training so that doctors conduct rape exams in a sensitive, non-judgmental manner.

Now the health ministry is revising the medical form that doctors examining rape victims use in order to include more detailed directions on how to proceed.

“Our total format is under revision right now,” said Dr. Sharma. This should be ready in February, he said.

But, he noted, this will only be binding on federal hospitals. Because health is the domain of each state in India, the health ministry can only issue recommendations to state health departments, Dr. Sharma said, although he is optimistic that “in most cases it’ll be followed.”

The only way to have uniform national binding guidelines would be at the direction of the Supreme Court, he said.

“If some court directive comes, then definitely it would be enforced onto the states,” he said.

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